Brian Browne, MD, recently presented testimony to the United States Sentencing Commission during a hearing on fentanyl, fentanyl analogs, and synthetic cannabinoids. He described a growing trend in the illicit drug trade, the addition of fentanyl to heroin packaging by “street pharmacists,” and its impact on unsuspecting users and on ambulance crews and emergency departments as they respond to overdoses. The commission, an independent agency within the judicial branch of the federal government, provides guidance to courts and assists in the development of crime policies. Zachary Dezman, MD, MS, MS, Assistant Professor, Department of Emergency Medicine, assisted Dr. Browne with the preparation of his testimony and attended the hearing.